Evaluation of platelet and its indices as a marker of neonatal sepsis: a prospective case control study

Choudhary, Ratana Ram; Makwana, Mohan; Mourya, Harish Kumar; Dabi, Jagdish; Gulati, Kartika

doi:10.18203/2349-3291.ijcp20183527

Cited by 13 publications

(19 citation statements)

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“…Elevated MPV (16) and PDW may be used as a marker for screening of sepsis. Choudhary et al (17) reported that high MPV, high PDW and thrombocytopenia are more common in late onset than early onset sepsis. Although, Shaaban and Safwat (18) found MPV as a marker of early onset sepsis.…”

Section: Discussionmentioning

confidence: 99%

Platelets Indices and Different Germs of Neonatal Sepsis

et al. 2019

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Background: Due to high incidence of sepsis as the main cause of neonatal mortality, early detection and proper treatment are important in reducing of neonatal mortality. Therefore, researchers are looking for a way of early diagnosis and treatment of sepsis. Platelet indices are one of these ways. But, can they determine different causing germs of neonatal sepsis? Methods: In this study, the septic neonates with positive blood culture were studied. Neonates with positive blood culture were divided into three groups; Gram-positive, Gram-negative and fungal infections. Platelet count and other parameters of platelets including PDW (platelet distribution width), and MPV (mean platelet volume) were evaluated, and compared with respect to different germs of septic neonates. Results: In this study 99 newborns with positive blood cultures were evaluated. Of these 13 neonates were excluded because of contaminated culture. In the remaining 86 cases thrombocytopenia, thrombocytosis, PDW, and MPV in different types of neonatal sepsis were evaluated and compared. Conclusions: Although thrombocytosis may be a laboratory finding for sepsis but it is not common in early onset sepsis. Elevated PDW is more common in Gram-negative infections and may be helpful in determining different germs of neonatal sepsis but mean values of PDW in Gram-negative infections are not more than that caused by other germs.

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Section: Discussionmentioning

confidence: 99%

Platelets Indices and Different Germs of Neonatal Sepsis

et al. 2019

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“…The normal value of MPV was < 10.8 fL and PDW was < 16.8 fL. 1,8 Soon after admission, 3 mL blood specimens were taken and processed for blood culture, total leukocyte count (TLC), micro-ESR, I/T neutrophil ratio, and CRP. Platelet indices (platelet count, MPV, PDW) were also determined with an automated hematology analyzer (SYMEX XN-1000R).…”

Section: Methodsmentioning

confidence: 99%

“…The situation is even more in low income underdeveloped countries. 1 However, neonatal sepsis is a diagnostic challenge, as there are overlapping signs and symptoms which preclude a specific diagnosis of sepsis. 2 Neonates are fragile and can deteriorate rapidly, thus, early diagnosis and prompt treatment is required.…”

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confidence: 99%

“…2 Neonates are fragile and can deteriorate rapidly, thus, early diagnosis and prompt treatment is required. 1,2 Clinical symptoms and signs of neonatal sepsis include the following: core temperature greater than 38.5°c or less than 36°c and/or temperature instability; cardiovascular instability: bradycardia in the absence of external vagal stimulus, beta-blockers or congenital heart disease or tachycardia in the absence of external stimulus, chronic drugs and painful stimuli and/or rhythm instability, reduced urinary output (less than 1 mL/kg/h), hypotension, mottled skin, impaired peripheral perfusion; skin and subcutaneous lesions: petechial rash, sclerema; respiratory instability: apnoea or tachypnea episodes; gastrointestinal disturbances: feeding intolerance, poor sucking, abdominal distention; irritability, lethargy, and hypotonia. 3 Laboratory signs of neonatal sepsis including: white blood cell (WBC) count: <5,000 cells/mm 3 or > 34,000 cells/mm 3 ; 4 immature-tototal neutrophil ratio (I/T)≥0.2; 3,4 C-reactive protein (CRP) > 9 mg/dL; 5 micro-ESR > 15 mm/ hour.…”

mentioning

confidence: 99%

“…To overcome these limitations, we usually rely on sepsis screening (CRP, micro ESR, WBC, and IT ratio), but its sensitivity and specificity vary. 1,2 Hematological changes induced by culture proven and probable neonatal sepsis have been used to make an early diagnosis and detect complications. Besides other hematological findings, changes in platelet count and platelet indices induced by neonatal sepsis have been the focus of many studies.…”

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confidence: 99%

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Diagnostic value of platelet indices for neonatal bacterial sepsis

Rohadi

Ramadanti

Indrayady

et al. 2020

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Background Neonatal bacterial sepsis is a major cause of neonatal morbidity and mortality worldwide. Blood culture as a gold standard, as well as C reactive protein (CRP), micro erythrocyte sedimentation rate (micro ESR), white blood count (WBC), and immature-to-total (I/T) ratio as a sepsis screens are currently used methods, but their utility may be limited due to delayed reporting. Platelet indices are one of the parameters which can be helpful in the diagnosis of neonatal bacterial sepsis. Objective To evaluate the use of platelet indices, either alone or in combination, with other laboratory screening parameters to diagnose neonatal bacterial sepsis. Methods Neonates admitted to the Neonatal Unit of RSUP Dr. Muhammad Hoesin Hospital, Palembang, South Sumatera, and showing symptoms of sepsis were included in this study. Subjects underwent testing for blood culture, sepsis screen (CRP, micro ESR, WBC, I/T ratio), and platelet indices [platelet count, mean platelet volume (MPV), and platelet distribution width (PDW)]. Results The 107 neonates who fulfilled the inclusion criteria consisted of 42 neonates with proven bacterial sepsis (positive blood culture), 10 neonates with probable bacterial sepsis (positive sepsis screen and negative blood culture), and 55 with clinical bacterial sepsis (negative in both blood culture and sepsis screen). There were no significant differences in platelet count among the proven bacterial sepsis, probable bacterial sepsis, and clinical bacterial sepsis groups. Platelet count < 150,000/ml, PDW ³ 16.8 fL, MPV ³ 10.8 fL and combinations of the three, were highly specific markers for proven sepsis, with specificities of 92.3%, 97%, 75.4%, and 80%, respectively. However, all of these parameters were poor predictive markers for positive cultures in neonatal clinical bacterial sepsis, with sensitivities of 19%, 7.1%, 35.7%, and 23.8%, respectively. Conclusion Platelet indices have high specificity but low sensitivity for the prediction of proven neonatal bacterial sepsis.

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The diagnostic and prognostic role of MiRNA 15b and MiRNA 378a in neonatal sepsis

Fouda

Midan

Ellaban

et al. 2021

Biochemistry and Biophysics Reports

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Background and objectives Sepsis is one of the major factors for both term and preterm babies with morbidity and mortality. On the basis of recent clinical trials, altered circulating micro-RNAs (miRNAs) may serve as possible biomarkers in sepsis for diagnosis and prognosis. The aim of this research is to assess the diagnostic and prognostic biomarkers of miRNA 15b and miRNA 378a for neonatal sepsis. Subjects & methods This study was carried out 25 neonates with sepsis admitted to neonatal ICU of Menoufia University Hospital and 25 healthy controls from February 2019 to May 2020. The relative quantification (RQ) of miRNA-15b and miRNA-378a expression was assessed using real time PCR technique. Results: Our results demonstrated that patients with sepsis had significantly higher level of MiRNA-15b than the healthy volunteers. On the other hand, patients with sepsis had significantly lower level of MiRNA-378a than the healthy volunteers. The ROC curve showed that the serum MiRNA-15b was a significant discriminator of sepsis with a combined sensitivity and specificity of 76% and 88% with cutoff point of 3.24. In addition, serum MiRNA-378a was a significant discriminator of sepsis with a combined sensitivity and specificity of 60% and 88% with cutoff point of 0.361. The miRNA-15b expression significantly correlated positive with respiratory rate (r =0.415,p =0.039), WBCs (r = 0.408, p =0.043), and CRP (r =0.407, p=0.043). Likewise, miRNA-378a expression significantly correlated negative with respiratory rate (r =-0.415p =0.024), WBCs (r =- 0.442, p =0.027), and CRP (r =- 0.459, p=0.021). Conclusion Both MiRNA 15b and 378a are promising biomarker for neonatal sepsis.

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Evaluation of platelet and its indices as a marker of neonatal sepsis: a prospective case control study

Cited by 13 publications

References 4 publications

Platelets Indices and Different Germs of Neonatal Sepsis

Platelets Indices and Different Germs of Neonatal Sepsis

Diagnostic value of platelet indices for neonatal bacterial sepsis

The diagnostic and prognostic role of MiRNA 15b and MiRNA 378a in neonatal sepsis

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